SimQuest proposes to design a prototype simulator for endovascular access and conduit upsizing that provides the most realistic training available, thus improving proficiency and reducing risk to patients. It will overcome the shortcomings of existing simulators, contain biofidelic haptics and novel metrics, and allow repeated practice so that proficiency is clearly defined and attainable. The goal is to provide trainees with a technologically advanced solution that allows development and practice of endovascular access/conduit upsizing with accurately simulated tools and realistic haptic feel. Unlike other trainers, the proposed simulator will start at needle puncture, move seamlessly into guidewire insertion through the just-inserted needle and then to the over-guidewire upsizing of the conduit catheter. The simulator will be built with an innovative combination of 3D printed physical trainer elements, augmented reality (AR), physics-based simulation, and haptics hardware interfaces. To facilitate expansion to other procedures, it will be developed using SimQuest's open-source platform, OpenSurgSim. During Phase I, the project team will work with leading endovascular surgery experts to determine feasibility, and develop task analysis, training goals, and metrics for the endovascular access tasks that are shared across specialties. They will also draft functional and performance specifications that will help drive the engineering design. Next, the team will design the hardware for a novel, two-part, endovascular access trainer that covers needle insertion and conduit upsizing, and manipulating off-the-shelf tools (sheath, catheter, and guidewire) from insertion location to target site. Long-range goals include completion by the end of Phase II of a state-of- the-art prototype endovascular surgery trainer that is ready for validation, field testing, and productization. This project will result in the first simulator to ofer complete training in endovascular access and conduit upsizing, simulating actual tasks in real-life fashion. It will improve clinical practice by (1) teaching endovascular access, use of guidewires/catheters, and conduit upsizing as a seamless process; (2) providing accurate haptic feel through an innovative design; (3) using clinical metrics defined by SMEs; and (4) containing a tissue-phantom mannequin providing sense of touch and AR for visual enhancements. Specific pathologies will be able to be incorporated using a virtual reality (VR) anatomical component.